Question 1

The parent of an adolescent diagnosed with schizophrenia asks the nurse, "My child's doctor ordered a PET. What kind of test is that?" Select the nurse's best reply.

Accepted Answer

A)  "This test uses a magnetic field and gamma waves to identify problem areas in the brain. Does your teenager have any metal implants?" 
B)  "PET means positron emission tomography. It is a special type of scan that shows blood flow and activity in the brain." 
C)  "A PET scan passes an electrical current through the brain and shows brain-wave activity. It can help diagnose seizures." 
D)  "It's a special X-ray that shows structures of the brain and whether there has ever been a brain injury." 
A)  "This test uses a magnetic field and gamma waves to identify problem areas in the brain. Does your teenager have any metal implants?" 
B)  "PET means positron emission tomography. It is a special type of scan that shows blood flow and activity in the brain." 
C)  "A PET scan passes an electrical current through the brain and shows brain-wave activity. It can help diagnose seizures." 
D)  "It's a special X-ray that shows structures of the brain and whether there has ever been a brain injury."

Question 2

The nurse prepares to assess a patient diagnosed with major depression for disturbances in circadian rhythms. Which question should the nurse ask this patient?

Accepted Answer

A)  "Have you ever seen or heard things that others do not?" 
B)  "What are your worst and best times of the day?" 
C)  "How would you describe your thinking?" 
D)  "Do you think your memory is failing?" 
A)  "Have you ever seen or heard things that others do not?" 
B)  "What are your worst and best times of the day?" 
C)  "How would you describe your thinking?" 
D)  "Do you think your memory is failing?"

Question 3

By which mechanism do selective serotonin reuptake inhibitors (SSRI) improve depression?

Accepted Answer

A)  Destroying increased amounts of serotonin 
B)  Making more serotonin available at the synaptic gap 
C)  Increasing production of acetylcholine and dopamine 
D)  Blocking muscarinic and $\alpha$1 norepinephrine receptors 
A)  Destroying increased amounts of serotonin 
B)  Making more serotonin available at the synaptic gap 
C)  Increasing production of acetylcholine and dopamine 
D)  Blocking muscarinic and $\alpha$1 norepinephrine receptors

Question 4

A patient begins therapy with a phenothiazine medication. What teaching should the nurse provide related to the drug's strong dopaminergic effect?

Accepted Answer

A)  Chew sugarless gum. 
B)  Increase dietary fiber. 
C)  Arise slowly from bed. 
D)  Report changes in muscle movement. 
A)  Chew sugarless gum. 
B)  Increase dietary fiber. 
C)  Arise slowly from bed. 
D)  Report changes in muscle movement.

Question 5

An obese patient has a diagnosis of schizophrenia. Medications that block which receptors would contribute to further weight gain?

Accepted Answer

A)  H? 
B)  5 HT? 
C)  Acetylcholine 
D)  Gamma-aminobutyric acid (GAB
A)  
A)  H? 
B)  5 HT? 
C)  Acetylcholine 
D)  Gamma-aminobutyric acid (GAB
A)

Question 6

A patient shows signs of fear as well as increased heart rate and blood pressure. The nurse suspects increased activity of which neurotransmitter?

Accepted Answer

A)  Gamma-aminobutyric acid (GAB
A)  
B)  Norepinephrine 
C)  Acetylcholine 
D)  Histamine 
A)  Gamma-aminobutyric acid (GAB
A)  
B)  Norepinephrine 
C)  Acetylcholine 
D)  Histamine

Question 7

A nurse prepares to administer a second-generation antipsychotic medication to a patient diagnosed with schizophrenia. Additional monitoring for adverse effects will be most important if the patient has which co-morbid health problems?

Accepted Answer

A)  Parkinson's disease 
B)  Grave's disease 
C)  Hyperlipidemia 
D)  Osteoarthritis 
E)  Diabetes 
A)  Parkinson's disease 
B)  Grave's disease 
C)  Hyperlipidemia 
D)  Osteoarthritis 
E)  Diabetes

Question 8

A drug blocks the attachment of norepinephrine to $\alpha$1 receptors. The patient may experience which of the following?

Accepted Answer

A)  Hypertensive crisis 
B)  Orthostatic hypotension 
C)  Severe appetite disturbance 
D)  An increase in psychotic symptoms 
A)  Hypertensive crisis 
B)  Orthostatic hypotension 
C)  Severe appetite disturbance 
D)  An increase in psychotic symptoms

Question 9

A patient with a long history of hypertension and diabetes now develops confusion. The health care provider wants to make a differential diagnosis between Alzheimer's disease and multiple infarcts. Which diagnostic procedure should the nurse expect to prepare the patient for first?

Accepted Answer

A)  Skull X-rays 
B)  Computed tomography (CT) scan 
C)  Positron emission tomography (PET) 
D)  Single-photon emission computed tomography (SPECT) 
A)  Skull X-rays 
B)  Computed tomography (CT) scan 
C)  Positron emission tomography (PET) 
D)  Single-photon emission computed tomography (SPECT)

Question 10

A patient has acute anxiety related to an automobile accident 2 hours ago. The nurse should teach the patient about medication from which group?

Accepted Answer

A)  Tricyclic antidepressants 
B)  Antipsychotic drugs 
C)  Antimanic drugs 
D)  Benzodiazepines 
A)  Tricyclic antidepressants 
B)  Antipsychotic drugs 
C)  Antimanic drugs 
D)  Benzodiazepines

Question 11

The therapeutic action of neurotransmitter inhibitors that block reuptake cause which of the following effects?

Accepted Answer

A)  Decreased concentration of the blocked neurotransmitter in the central nervous system 
B)  Increased concentration of the blocked neurotransmitter in the synaptic gap 
C)  Destruction of receptor sites specific to the blocked neurotransmitter 
D)  Limbic system stimulation 
A)  Decreased concentration of the blocked neurotransmitter in the central nervous system 
B)  Increased concentration of the blocked neurotransmitter in the synaptic gap 
C)  Destruction of receptor sites specific to the blocked neurotransmitter 
D)  Limbic system stimulation

Question 12

The laboratory report for a patient taking clozapine (Clozaril) shows a white blood cell count of 3 000 mm3. Select the nurse's best action.

Accepted Answer

A)  Report the results to the health care provider immediately. 
B)  Administer the next dose as prescribed. 
C)  Give aspirin and force fluids. 
D)  Repeat the laboratory test. 
A)  Report the results to the health care provider immediately. 
B)  Administer the next dose as prescribed. 
C)  Give aspirin and force fluids. 
D)  Repeat the laboratory test.

Question 13

A patient has disorganized thinking associated with schizophrenia. Neuroimaging would likely show dysfunction in which part of the brain?

Accepted Answer

A)  Hippocampus 
B)  Frontal lobe 
C)  Cerebellum 
D)  Brain stem 
A)  Hippocampus 
B)  Frontal lobe 
C)  Cerebellum 
D)  Brain stem

Question 14

The nurse administers a medication that potentiates the action of gamma-aminobutyric acid (GABA). Which effect would be expected?

Accepted Answer

A)  Reduced anxiety 
B)  Improved memory 
C)  More organized thinking 
D)  Fewer sensory perceptual alterations 
A)  Reduced anxiety 
B)  Improved memory 
C)  More organized thinking 
D)  Fewer sensory perceptual alterations

Question 15

A nurse caring for a patient taking a selective serotonin reuptake inhibitor (SSRI) will develop outcome criteria related to which of the following?

Accepted Answer

A)  Coherent thought processes 
B)  Improvement in depression 
C)  Reduced levels of motor activity 
D)  Decreased extrapyramidal symptoms 
A)  Coherent thought processes 
B)  Improvement in depression 
C)  Reduced levels of motor activity 
D)  Decreased extrapyramidal symptoms

Exam 11: Psychotropic Drugs

The parent of an adolescent diagnosed with schizophrenia asks the nurse, "My child's doctor ordered a PET. What kind of test is that?" Select the nurse's best reply.

The nurse prepares to assess a patient diagnosed with major depression for disturbances in circadian rhythms. Which question should the nurse ask this patient?

By which mechanism do selective serotonin reuptake inhibitors (SSRI) improve depression?

A patient begins therapy with a phenothiazine medication. What teaching should the nurse provide related to the drug's strong dopaminergic effect?

An obese patient has a diagnosis of schizophrenia. Medications that block which receptors would contribute to further weight gain?

A patient shows signs of fear as well as increased heart rate and blood pressure. The nurse suspects increased activity of which neurotransmitter?

A nurse prepares to administer a second-generation antipsychotic medication to a patient diagnosed with schizophrenia. Additional monitoring for adverse effects will be most important if the patient has which co-morbid health problems?

A drug blocks the attachment of norepinephrine to α\alphaα 1 receptors. The patient may experience which of the following?

A patient with a long history of hypertension and diabetes now develops confusion. The health care provider wants to make a differential diagnosis between Alzheimer's disease and multiple infarcts. Which diagnostic procedure should the nurse expect to prepare the patient for first?

A patient has acute anxiety related to an automobile accident 2 hours ago. The nurse should teach the patient about medication from which group?

The therapeutic action of neurotransmitter inhibitors that block reuptake cause which of the following effects?

The laboratory report for a patient taking clozapine (Clozaril) shows a white blood cell count of 3 000 mm3. Select the nurse's best action.

A patient has disorganized thinking associated with schizophrenia. Neuroimaging would likely show dysfunction in which part of the brain?

The nurse administers a medication that potentiates the action of gamma-aminobutyric acid (GABA). Which effect would be expected?

A nurse caring for a patient taking a selective serotonin reuptake inhibitor (SSRI) will develop outcome criteria related to which of the following?

Mental Health and Mental Illness

Historical Overview of Psychiatric Mental Health Nursing

Overview of Psychiatric Mental Health Nursing Care Within Various Settings

Relevant Theories and Therapies for Nursing Practice

Understanding Responses to Stress

The Nursing Process and Standards of Care for Psychiatric Mental Health Nursing

Ethical Responsibilities and Legal Obligations for Psychiatric Mental Health Nursing Practice

Cultural Considerations for Psychiatric Mental Health Nursing

Therapeutic Relationships

Communication and the Clinical Interview

Anxiety and Related Disorders

Depressive Disorders

Bipolar Disorders

Schizophrenia Spectrum and Other Psychotic Disorders

Eating and Feeding Disorders

Neurocognitive Disorders

Psychoactive Substance Use and Treatment

Personality Disorders

Sleepwake Disorders

Crisis and Disaster

Suicide and Nonsuicidal Self-Injury

Anger, Aggression, and Violence

Interpersonal Violence: Child, Older Adult, and Intimate Partner Abuse

Sexual Assault

Sexuality and Gender

Disorders of Children and Adolescents

Psychosocial Needs of the Older Adult

Living With Recurrent and Persistent Mental Illness

Psychological Needs of Patients With Medical Conditions

Care for the Dying and for Those Who Grieve

Forensic Psychiatric Nursing

Therapeutic Groups

Family Interventions

Integrative and Complimentary Therapies

Filters

A drug blocks the attachment of norepinephrine to $\alpha$ 1 receptors. The patient may experience which of the following?

The laboratory report for a patient taking clozapine (Clozaril) shows a white blood cell count of 3 000 mm³. Select the nurse's best action.